NEW LONDON CANCER CENTER, P.C. (NPI# 1376596825) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376596825 |
| Entity Type | Organization |
| Organization Name | NEW LONDON CANCER CENTER, P.C. |
| Other Organization Name | NEW LONDON CANCER CENTER, INC. |
| Practice Address |
196 Parkway S Suite 303 Waterford CT 06385-1234 |
| Mailing Address |
196 Parkway S Suite 304 Waterford CT 06385-1234 |
| Practice Telephone | 8604434455 |
| Practice Fax Number | 8604478961 |
| Mailing Telephone | 8604427027 |
| Mailing Fax Number | 8668619119 |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2013-09-25 |
| Authorized Official Name | DR. MITHLESH GOVIL (PHYSICIAN/OWNER) |
| Authorized Official Telephone | 8604434455 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
CT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | MEDICAID APRN GROUP | 008022601 | 01 |
| CT | 004222600 | 05 |
| Other Name | Type Code |
|---|---|
| New London Cancer Center, Inc. | Former Legal Business Name - Organization |
| Street Address |
196 PARKWAY S SUITE 303 |
| City | WATERFORD |
| State | CT |
| Zip Code | 06385-1234 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235136094 | Mithlesh Govil | Internal Medicine | 196 Parkway S, Suite 303, Waterford, CT 06385-1234 | 2005-07-07 |
| 1427431840 | Julie Zito | Physician Assistant | 196 Parkway S, Suite303, Waterford, CT 06385-1234 | 2015-07-02 |
| 1275933095 | Crossroads Primary Care, LLC | Durable Medical Equipment & Medical Supplies | 196 Parkway S, Suite 304, Waterford, CT 06385-1234 | 2014-08-28 |
| 1255745014 | Jacqueline Lagasse | Registered Nurse | 196 Parkway S, Suite 303, Waterford, CT 06385-1234 | 2014-06-19 |
| 1093140162 | Kenneth R Kierstein | Podiatrist | 196 Parkway S, Suite 302, Waterford, CT 06385-1234 | 2013-09-09 |
| 1528369006 | Carol Ann Greene | Occupational Therapy Assistant | 196 Parkway S, Suite 201, Waterford, CT 06385-1234 | 2010-11-15 |
| 1073827465 | Sarah R Donahue | Nurse Practitioner | 196 Parkway S, Suite 303, Waterford, CT 06385-1234 | 2010-07-28 |
| 1861724106 | Valmarie Ramos | Internal Medicine | 196 Parkway S, Suite 303, Waterford, CT 06385-1234 | 2010-02-11 |
| 1326279035 | Jodi V Hodge | Physician Assistant | 196 Parkway S, Suite 303, Waterford, CT 06385-1234 | 2009-07-29 |
| 1023261690 | Katherine Lm Bender | Nurse Practitioner | 196 Parkway S, Suite 304, Waterford, CT 06385-1234 | 2008-10-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073140331 | Megan Plattner | Hearing Instrument Specialist | Waterford Commons 903-915 Hartford Tpke, Store 16, Waterford, CT 06385 | 2020-03-26 |
| 1174032288 | Winakor's Healing Practice | Social Worker | 758 Broad St. Ext., Waterford, CT 06385 | 2017-09-21 |
| 1972029494 | Michael C Marshall | Social Worker | 112 Great Neck Road, Empowerment Counseling Services, LLC, Waterford, CT 06385 | 2017-08-16 |
| 1750810297 | Taylor Anne Tomasetti | Occupational Therapist | 24 Doyle Rd, Waterford, CT 06385 | 2017-06-08 |
| 1366993214 | Ascension Naturopathic Healing Center LLC | Clinic/Center | 175 Boston Post Road, Floor 1, Waterford, CT 06385 | 2016-10-16 |
| 1467815126 | Sanborn Optometric Associates | Clinic/Center | 900 Hartford-new London Turnpike, Waterford, CT 06385 | 2016-03-31 |
| 1225499007 | Martin L Hellman, Od, Faao, LLC | Optometrist | 850 Waterford Tpke, Waterford, CT 06385 | 2016-03-08 |
| 1861876211 | Mallory Rose Devona | Counselor | 2 Leary Dr, Waterford, CT 06385 | 2015-07-15 |
| 1336571843 | Carrie M Reynolds | Surgery | 5 Scenic View Dr, Waterford, CT 06385 | 2013-08-07 |
| 1194085076 | Meghana Rao Brito | Internal Medicine | 196 Waterford Pkwy S Ste 103, Waterford, CT 06385 | 2012-05-24 |
| Find all providers in zip 06385 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316927882 | Sandeep Garg | Internal Medicine | 4000 Highland Rd Ste 104, Waterford, Waterford, MI 48328-2163 | 2006-01-19 |
| 1952344004 | New London Cancer Center, P.c | Internal Medicine | 196 Parkway S, Suite 303, Waterford, CT 06385-1219 | 2006-06-14 |
| 1568453942 | Naeem Tahir | Internal Medicine | 196 Parkway S, Suite 303, Waterford, CT 06385-1234 | 2005-11-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154751907 | David S Fischer | Internal Medicine | 17 Abigail St, Milford, CT 06460-7918 | 2013-11-14 |
| 1265746879 | Eric Bleickardt | Internal Medicine | 3 Hidden Brook Rd, Hamden, CT 06518-1764 | 2010-08-06 |
| 1467763946 | Kelsey Thompson Martin | Internal Medicine | 240 Indian River Rd Ste A1, Orange, CT 06477-3690 | 2010-06-29 |
| 1780907295 | Kenneth L Sacks | Internal Medicine | 10 Oyster Landing Rd, Milford, CT 06460-6566 | 2010-03-11 |
| 1396981668 | Michael W Rosen | Internal Medicine | 32 Mackay Farm Rd, Woodbury, CT 06798-2509 | 2008-12-17 |
| 1083879134 | Jia Li | Internal Medicine | 950 Campbell Ave # 111d, West Haven, CT 06516-2770 | 2008-07-28 |
| 1760643407 | Sudhanshu Bharat Mulay | Internal Medicine | 114 Woodland Street / Cancer Center, Saint Francis Medical Group, Inc, Hartford, CT 06105-0000 | 2008-06-24 |
| 1194938324 | Anamika Katoch | Internal Medicine | 1075 Chase Pkwy Ste B, Harold Leever Cancer Center, Waterbury, CT 06708-2948 | 2007-05-07 |
| 1760694327 | Joseph Donadio | Internal Medicine | 140 Blue Hills Rd, Durham, CT 06422-3100 | 2007-05-04 |
| 1720136757 | Wylie David Hosmer | Internal Medicine | 55 Meriden Ave Ste 1a, Southington, CT 06489-3237 | 2007-01-08 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.